Medical Records Examiner

If you are seeking an opportunity to leverage your expertise as a registered nurse in a role that does not involve direct patient care, you have found the ideal position! The Pennsylvania Department of Human Services (DHS), specifically within the Office of Medical Assistance Programs (OMAP), is in search of a committed registered nurse to manage and oversee programs designed for medical assistance recipients. This is your chance to take charge of your professional journey while making a significant impact on the lives of millions of Pennsylvanians who rely on essential benefits. Embrace this opportunity to contribute to the healthcare system in a meaningful way, ensuring that those in need receive the support and resources they deserve.

As a Medical Records Examiner within the Division of Clinical Review (DCR) at the Bureau of Fee-for-Service Programs (BFFSP), your primary role will involve the thorough examination and oversight of specific services provided to medical assistance (MA) recipients. This critical function ensures that medical necessity is clearly established, that the chosen service locations are suitable, and that all eligible and necessary services receive approval for payment in compliance with relevant state and federal laws and regulations. Success in this position hinges on possessing exceptional written and verbal communication skills, as you will frequently engage with both internal and external stakeholders. This is a valuable opportunity to contribute to the integrity of healthcare services and ensure that recipients receive the support they need.

Interested in learning more? Additional details regarding this position can be found in the position description.

Work Schedule and Additional Information:

• Full-time employment
• Work hours are 7:30 AM to 4:00 PM, Monday - Friday, with a 60-minute lunch.
• Home Headquartered: You may have the opportunity to work from home (telework) part-time up to 3 days per week. In order to telework, you must have a securely configured high-speed internet connection and work from an approved location inside Pennsylvania. If you are unable to telework, you will have the option to report to the headquarters office in Harrisburg. The ability to telework is subject to change at any time. Additional details may be provided during the interview.
• Salary: In some cases, the starting salary may be non-negotiable.
• You will receive further communication regarding this position via email. Check your email, including spam/junk folders, for these notices.
  

QUALIFICATIONS

Minimum Experience and Training Requirements:

• Three years of professional experience in the field of medical assistance, health care services, or human services; or
• An equivalent combination of experience and training.

Special Requirements:

• You must possess active authorization to practice as a Registered Nurse in Pennsylvania.
• All employees possessing an active temporary practice permit must obtain licensure as a Registered Nurse within the one (1) year period defined by the Pennsylvania State Board of Nursing.

• You must meet the PA residency requirement. For more information on ways to meet PA residency requirements, follow the link and click on Residency.
• You must be able to perform essential job functions.

How to Apply:

• Resumes, cover letters, and similar documents will not be reviewed, and the information contained therein will not be considered for the purposes of determining your eligibility for the position. Information to support your eligibility for the position must be provided on the application (i.e., relevant, detailed experience/education).
• If you are claiming education in your answers to the supplemental application questions, you must attach a copy of your college transcripts for your claim to be accepted toward meeting the minimum requirements. Unofficial transcripts are acceptable.
• Your application must be submitted by the posting closing date. Late applications and other required materials will not be accepted.
• Failure to comply with the above application requirements may eliminate you from consideration for this position.

Veterans:

Telecommunications Relay Service (TRS):

If you are contacted for an interview and need accommodations due to a disability, please discuss your request for accommodations with the interviewer in advance of your interview date.

The Commonwealth is an equal employment opportunity employer and is committed to a diverse workforce. The Commonwealth values inclusion as we seek to recruit, develop, and retain the most qualified people to serve the citizens of Pennsylvania. The Commonwealth does not discriminate on the basis of race, color, religious creed, ancestry, union membership, age, gender, sexual orientation, gender identity or expression, national origin, AIDS or HIV status, disability, or any other categories protected by applicable federal or state law. All diverse candidates are encouraged to apply.